US9980760B2 - Step off bone plates, systems, and methods of use - Google Patents

Abstract

The present invention discloses a step off bone plate, bone plate insertion system, and method of use. The step off bone plate includes a body with a first end and a second end, the body includes a first portion with a first curvature, a second portion with a second curvature, and a connecting portion coupled to the first portion at a first end and coupled to the second portion at a second end. The bone plate insertion system includes a step off bone plate and an alignment guide apparatus. A method of using the step off bone plate is also disclosed.

Description

FIELD OF THE INVENTION

The present invention relates generally to the field of orthopedics related to orthopedic bone plates, specifically, step off bone plates, bone plate insertion systems, and methods for using the bone plates.

BACKGROUND OF THE INVENTION

Currently, the lapidus procedure is performed at the base of the first metatarsal and involves the cuneiform. Typically, surgeons perform sagittal saw cuts to provide the proper realignment of the joint. The cutting of the joint shortens the first metatarsal and could off load the sesamoids which may alter normal pressures on the foot. In order to correct for this shortening, surgeons will not only correct the position in the transverse plane (hallux valgus), but will also plantar translate or angulate the metatarsal to reload the sesamoids. In order to achieve this, surgeons may utilize an off-set style plate that is positioned dorsal medial on the joint thus translating the cut bone down and over. However, a dorsal medial positioned plate is not ideal due to the forces imparted on the plate post-operatively.

Accordingly, the present invention contemplates a newly configured and improved bone plate and methods which overcome the above-referenced problems and others.

SUMMARY OF THE INVENTION

The present invention is directed toward step off bone plates, bone plate insertion systems, and methods of using the devices.

In one aspect, provided herein is a step off bone plate. The step off bone plate may include, for example, a body with a first end and a second end. The body may include a first portion with a first curvature, a second portion with a second curvature, and a connecting portion coupled to the first portion at a first end and coupled to the second portion at a second end.

In another aspect, provided herein is a bone plate insertion system. The bone plate insertion system may include, for example, a bone plate with a first and second end and an alignment guide apparatus. The bone plate may include, for example, a first portion with a first curvature, a second portion with a second curvature, and a connecting portion. The connecting portion connects the first portion to the second portion.

In yet another aspect, provided herein is a method for using the step off bone plate. The method includes, for example, preparing and aligning a patient's bones. The method may also include selecting a step off bone plate and attaching an insertion guide to the step off bone plate. The method may further include aligning the step off bone plate over the bones and securing the bone plate to the bones with temporary fixation members. In addition, the method may include inserting a guide wire through the insertion guide and across the bones and removing the insertion guide from the step off bone plate. The method may further include inserting a screw over the guide wire and across the bones. The method may also include inserting bone screws to secure the plate to the patient's bones. Further, the method may include closing the patient.

These, and other objects, features and advantages of this invention will become apparent from the following detailed description of the various aspects of the invention taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF DRAWINGS

The accompanying drawings, which are incorporated in and constitute a part of the specification, illustrate embodiments of the invention and together with the detailed description herein, serve to explain the principles of the invention. It is emphasized that, in accordance with the standard practice in the industry, various features are not drawn to scale. In fact, the dimensions of the various features may be arbitrarily increased or reduced for clarity of discussion. The drawings are only for purposes of illustrating preferred embodiments and are not to be construed as limiting the invention.

FIG. 1 is a top perspective view of a step off bone plate, in accordance with an aspect of the present invention;

FIG. 2 is a bottom perspective view of the step off bone plate ofFIG. 1, in accordance with an aspect of the present invention;

FIG. 3 a first side view of the step off bone plate ofFIG. 1, in accordance with an aspect of the present invention;

FIG. 4 is a second side view of the step off bone plate ofFIG. 1, in accordance with an aspect of the present invention;

FIG. 5 is a front view of the step off bone plate ofFIG. 1, in accordance with an aspect of the present invention;

FIG. 6 is a back view of the step off bone plate ofFIG. 1, in accordance with an aspect of the present invention;

FIG. 7 is a top view of the step off bone plate ofFIG. 1, in accordance with an aspect of the present invention;

FIG. 8 is a bottom view of the step off bone plate ofFIG. 1, in accordance with an aspect of the present invention;

FIG. 9 is a top perspective view of another step off bone plate, in accordance with an aspect of the present invention;

FIG. 10 is a bottom perspective view of the step off bone plate ofFIG. 9, in accordance with an aspect of the present invention;

FIG. 11 a first side view of the step off bone plate ofFIG. 9, in accordance with an aspect of the present invention;

FIG. 12 is a second side view of the step off bone plate ofFIG. 9, in accordance with an aspect of the present invention;

FIG. 13 is a front view of the step off bone plate ofFIG. 9, in accordance with an aspect of the present invention;

FIG. 14 is a back view of the step off bone plate ofFIG. 9, in accordance with an aspect of the present invention;

FIG. 15 is a top view of the step off bone plate ofFIG. 9, in accordance with an aspect of the present invention;

FIG. 16 is a bottom view of the step off bone plate ofFIG. 9, in accordance with an aspect of the present invention; and

FIG. 17 is a perspective view of a bone plate alignment guide apparatus, in accordance with an aspect of the present invention;

FIG. 18 is a side view of the bone plate alignment guide apparatus ofFIG. 17, in accordance with an aspect of the present invention;

FIG. 19 is an exploded side view of the bone plate alignment guide apparatus ofFIG. 17, in accordance with an aspect of the present invention;

FIG. 20 is a bottom perspective view of the body of the bone plate alignment guide apparatus ofFIG. 17, in accordance with an aspect of the present invention;

FIG. 21 is an end perspective view of the body of the bone plate alignment guide apparatus ofFIG. 17, in accordance with an aspect of the present invention; and

FIG. 22 depicts one embodiment of a method for using the step off bone plate, in accordance with an aspect of the present invention.

DETAILED DESCRIPTION FOR CARRYING OUT THE INVENTION

Generally stated, disclosed herein is an embodiment of a step off bone plate. The terms “step off bone plate,” “bone plate,” and “plate” may be used interchangeably herein as they essentially refer to the same device. Further, a method for using the step off bone plate is discussed.

In this detailed description and the following claims, the words proximal, distal, anterior, posterior, medial, lateral, superior, inferior, dorsal and plantar are defined by their standard usage for indicating a particular part of a bone or implant according to the relative disposition of the natural bone or directional terms of reference. For example, “proximal” means the portion of an implant nearest the torso, while “distal” indicates the portion of the implant farthest from the torso. As for directional terms, “anterior” is a direction towards the front side of the body, “posterior” means a direction towards the back side of the body, “medial” means towards the midline of the body, “lateral” is a direction towards the sides or away from the midline of the body, “superior” means a direction above and “inferior” means a direction below another object or structure. Further, specifically in regards to the foot, the term “dorsal” refers to the top of the foot and the term “plantar” refers the bottom of the foot.

Referring to the drawings, wherein like reference numerals are used to indicate like or analogous components throughout the several views, and with particular reference toFIGS. 1-8, abone plate100, for example, a step off bone plate, is shown. Thebone plate100 is designed for medial wall positioning to provide abone plate100 with a dual curvature along the long axis of theplate100 to match the correction of a more dorsally located plate. The dual curvatures of theplate100 allow for theplate100 to be positioned medially thereby providing a more stable construct and a plate that resists bending.

The step offbone plate100, as shown inFIGS. 1-8, includes abody102 with afirst end104, asecond end106, and atransition point108 positioned between thefirst end104 and thesecond end106. Thebody102 may include afirst portion110, asecond portion120, and a connectingportion140 coupling thefirst portion110 to thesecond portion120. Thefirst portion110 may extend from thefirst end104 to thetransition point108. Thesecond portion120 may extend from thetransition point108 to thesecond end106. The connectingportion140 may be positioned between thefirst portion110 andsecond portion120 at thetransition point108.

As shown inFIGS. 1-8, thefirst portion110 may have at least oneslot112 near thefirst end104 of thebody102 and at least onefirst opening114 positioned between the at least oneslot112 and thetransition point108. As depicted, the at least onefirst opening114 may be positioned adjacent to the at least oneslot112. Theslot112 andfirst opening114 may be, for example, aligned along the center of thebody102. Theopening114 may be, for example, a screw hole for receiving a threaded fastener or screw (not shown). Thefirst portion110 may also include an extension member orarm116, as shown inFIGS. 1-3 and 5-8. Theextension member116 may extend out from a side of thebody102 of thefirst portion110 and may include at least onesecond opening118. Theextension member116 may extend out from the body between thefirst end104 and thetransition point108 and may be angled with respect to the longitudinal axis of thebody102. For example, theextension member116 may extend out from the body near thefirst opening114. Theextension member116 may be angled toward thesecond end106 of thebody102. Theextension member116 may also be curved as it extends away from thebody102 as seen inFIG. 5. The curvature of theextension member116 may, for example, match the curvature of the bone engaging thefirst portion110. Theextension member116 may be configured to reinforce the plantar aspect of the foot to reduce or restrict gapping after surgery by providing plantar support from a medial positionedplate100. Theextension member116 may also be positioned in the direction that matches the normal transition of stress during the gait cycle to provide the greatest strength during peak loads. Thefirst portion110 of theplate100 may include a dual curvature with, for example, a first curvature perpendicular to the long axis of theplate100 and a second curvature along the long axis of theplate100. The first curvature may have a radius of, for example, approximately 8 mm to 60 mm, and the second curvature may have a radius of, for example, approximately 50 mm to 300 mm.

Thesecond portion120, as shown inFIGS. 1-2 and 7-8, may include afirst lobe122 and asecond lobe126 extending out from thebody102. Thefirst lobe122 may be offset from thesecond lobe126 forming an angled surface at thesecond end106 of thebody102 as seen inFIG. 5. Thefirst lobe122 may include athird opening124 and thesecond lobe124 may include afourth opening128. Alternative numbers oflobes122,126 are also contemplated to provide for additional fastening locations for securing theplate100 to the patient's bones. Theopenings124,128 may be, for example, screw holes for receiving threaded fasteners or screws (not shown). Thesecond portion120 may also include a rampedportion130 positioned at thesecond end106 along the angled surface. The rampedportion130 is gradually angled from the bottom surface to the top surface of thebody102 and provides a surface that allows a tendon, for example, the anterior tibialis tendon, to glide over theplate100. By allowing the tendon to glide over the plate soft-tissue irritation is eliminated. Existing plate designs cause the tendon to pop or jump over the plate resulting in patient discomfort. The rampedportion130 may decrease the thickness of the plate at thesecond end106, while still maintaining adequate thickness to prevent screw prominence.

Referring now toFIGS. 1-4, the connectingportion140 is positioned relatively perpendicular to and couples thefirst portion110 and thesecond portion120. The connectingportion140 provides a change in elevation or “step up” from thefirst portion110 to thesecond portion120. The connectingportion140 may provide a step up of, for example, approximately 1 mm to 10 mm. The connectingportion140 may include asloped surface142 on the top of thebody102. In addition, the connectingportion140 may include afirst transition portion144 extending from thefirst portion110 to thetransition point108 and asecond transition portion146 extending perpendicular to thefirst transition portion144 from thetransition point108 to thesecond portion120. Thefirst transition portion144 andsecond transition portion146 may be relatively planar.

As shown inFIGS. 3-6, theplate100 may include multiple curved surfaces. Theplate100 may include dual curvatures with respect to the longitudinal axis of theplate100, as shown inFIGS. 5-6. Thefirst portion110 may have a first curvature in a medial-lateral direction with respect to the longitudinal axis of theplate100. The first curvature may have a range of, for example, approximately 8 mm to 60 mm. Thesecond portion120 may have a second curvature in the medial-lateral direction along with respect to the longitudinal axis of theplate100 along the bottom surface. The second curvature may have a range from, for example, approximately 10 mm to 60 mm. The first curvature and second curvature may be different inplate100 to allow for theplate100 to be used on the medial aspect of a patient's foot. As shown inFIGS. 3-4, thebody102 of theplate100 may have a third curvature in line with the longitudinal axis and the third curvature may have a range of, for example, approximately 50 mm to 300 mm.

Referring now toFIGS. 9-16, another step offbone plate200 is shown. Thebone plate200 may include abody202 with afirst end204, asecond end206, and atransition point208 positioned between thefirst end204 and thesecond end206. Thebody202 may include afirst portion210, asecond portion220, and a connectingportion240 attaching thefirst portion210 to thesecond portion220. Thefirst portion210 may extend from thefirst end204 to thetransition point208. Thesecond portion220 may extend from thetransition point208 to thesecond end206. The connectingportion240 may be positioned between thefirst portion210 andsecond portion220 at thetransition point208.

As shown inFIGS. 9-16, thefirst portion210 may have at least oneslot212 near thefirst end204 of thebody202, at least onefirst opening214 positioned adjacent the at least oneslot212, and at least onechannel232 positioned between the at least onefirst opening214 and thetransition point208. As depicted, the at least onechannel232 may be positioned adjacent to the at least oneslot212. Theslot212,first opening214, andchannel232 may be, for example, aligned along the center of thebody202. Theslot212 may be, for example, a compression screw hole for receiving a threaded fastener or screw (not shown). Theopening214 may be, for example, a screw hole for receiving a threaded fastener or screw (not shown). Thechannel232 may be, for example, an opening for receiving an insertion tool. Thefirst portion210 may also include an extension member orarm216, as shown inFIGS. 9-11 and 13-16. Theextension member216 may extend out from a side of thebody202 of thefirst portion210 and may include at least onesecond opening218. Theextension member216 may extend out from the body between thefirst end204 and thetransition point208 and may be angled with respect to the longitudinal axis of thebody202. For example, theextension member216 may extend out from the body near thefirst opening214 andchannel232. Theextension member216 may be angled toward thesecond end206 of thebody202. Theextension member216 may also be curved as it extends away from thebody202 as seen inFIG. 13. The curvature of theextension member216 may, for example, match the curvature of the bone engaging thefirst portion210. Theextension member216 may be configured to reinforce the plantar aspect of the foot to reduce or restrict gapping after surgery by providing plantar support from a medial positionedplate200. Theextension member216 may also be positioned in the direction that matches the normal transition of forces during the gait cycle to provide the greatest strength during peak loads. Theextension member216 may be shorter than theextension member116. In addition, theextension member216 may be positioned closer to thetransition point208 than theextension member116 is positioned to thetransition point108.

Thefirst portion210 of theplate200 may include a dual curvature with, for example, a first curvature perpendicular to the long axis of theplate200 and a second curvature along the long axis of theplate200. The first curvature may have a radius of, for example, approximately 8 mm to 60 mm, and the second curvature may have a radius of, for example, approximately 50 mm to 300 mm. Thefirst portion210 near thefirst end204 and including theslot212 may be angled relative to the second curvature, as shown inFIGS. 11 and 12.

Thesecond portion220, as shown inFIGS. 9-10 and 15-16, may include afirst lobe222 and asecond lobe226 extending out from thebody202. Thefirst lobe222 may be offset from thesecond lobe226 forming an angled surface at thesecond end206 of thebody202 as seen inFIG. 15. Thefirst lobe222 may include athird opening224 and thesecond lobe224 may include afourth opening228. Alternative numbers oflobes222,226 are also contemplated to provide for additional fastening locations for securing theplate200 to the patient's bones. Theopenings224,228 may be, for example, screw holes for receiving threaded fasteners or screws (not shown). Thesecond portion220 may also include a rampedportion230 positioned at thesecond end206 along the angled surface. The rampedportion230 is gradually angled from the bottom surface to the top surface of thebody202 and provides a surface that allows a tendon, for example, the anterior tibialis tendon, to glide over theplate200. The rampedportion230 has a more pronounced angle than the rampedportion130. As discussed in greater detail above with respect to rampedportion130, by allowing the tendon to glide over the plate soft-tissue irritation is eliminated. The rampedportion230 may decrease the thickness of the plate at thesecond end206, while still maintaining adequate thickness to prevent screw prominence.

Referring now toFIGS. 9-12, the connectingportion240 is positioned relatively perpendicular to and couples thefirst portion210 and thesecond portion220. The connectingportion240 provides a change in elevation or “step up” from thefirst portion210 to thesecond portion220. The connectingportion240 may provide a step up of, for example, approximately 1 mm to 10 mm. The connectingportion240 may include asloped surface242 on the top of thebody202. In addition, the connectingportion240 may include afirst transition portion244 extending from thefirst portion210 to thetransition point208 and asecond transition portion246 extending perpendicular to thefirst transition portion244 from thetransition point208 to thesecond portion220. Thefirst transition portion244 andsecond transition portion246 may be relatively planar.

As shown inFIGS. 11-16, theplate200 may include multiple curved surfaces. Theplate200 may include dual curvatures with respect to the longitudinal axis of theplate200, as shown inFIGS. 13-14. Thefirst portion210 may have a first curvature in a medial-lateral direction with respect to the longitudinal axis of theplate200. The first curvature may have a range of, for example, approximately 8 mm to 60 mm. Thesecond portion220 may have a second curvature in the medial-lateral direction along with respect to the longitudinal axis of theplate200 along the bottom surface. The second curvature may have a range from, for example, approximately 10 mm to 60 mm. The first curvature and second curvature may be different inplate200 to allow for theplate200 to be used on the medial aspect of a patient's foot. As shown inFIGS. 11-12, thebody202 of theplate200 may have a third curvature along a portion of theplate200 in line with the longitudinal axis and the third curvature may have a range of, for example, approximately 50 mm to 300 mm. Thefirst end204 of theplate200 may not be curved along the longitudinal axis of the plate. The plate curvatures may have radii that are positioned off axis to provide strength to theplates100,200 and to enable placement of theplates100,200 on the medial aspect of the patient's bone.

Referring now toFIGS. 17-21, a bone platealignment guide apparatus300 is shown. The bone platealignment guide apparatus300 may include abody310, acoupling member330, a guidepin tissue protector340. Theapparatus300 may also include a guide wire or pin (not shown) and a fastener (not shown). Thecoupling member330 may include aknob332 and ashaft334. Theshaft portion334 may include anengagement portion336 for coupling to a bone plate, for example,bone plate100 or200, and agroove338 which may assist with coupling theengagement portion336 to a bone plate. Theengagement portion336 may be, for example, threaded to engage corresponding threads in an opening in a bone plate, deformable to be removeably press fit into the opening in the bone plate, or another similar configuration that achieves a coupling of theguide apparatus300 to a bone plate, such as,bone plate100,200, or the like. The guide wire (not shown) may be, for example, a pin, k-wire, olive wire, or the like. The fastener (not shown) may be, for example, a compression screw, lag screw, headless screw, or a solid screw, for crossing a joint or fracture.

The guidepin tissue protector340, as shown inFIGS. 17-19, may include ahandle portion342 at a first end and ashaft portion344 extending away from thehandle portion342 to atip348 at a second end. Theshaft344 may taper at the second end to form thetip348. The guidepin tissue protector340 may also include a throughhole346 extending from the first end to the second end to enable a guide wire (not shown) to pass through thetissue protector340 and engage the patient's bone.

As shown inFIGS. 17-21, thebody310 may include anarm312 with anattachment portion314 at a first end and analignment portion316 at a second end. Thealignment portion316 of thebody310 may be, for example, a variable hole alignment portion, and may include a plurality ofholes318. The plurality ofholes318 may be, for example four holes that are positioned in a square arrangement. The plurality ofholes318 may be straight or angled to a desired insertion position relative to thearm312 of thebody310. By way of specific example, the two left holes and two right holes may, for example, each be slightly angled toward the center of thealignment portion316 such that each of the side holes converge toward each other. In addition, the top two holes and the bottom two holes may each be slightly angled toward the center of thealignment portion316 such that each of the holes converge toward each other. Alternative angled arrangements for theholes318 are also contemplated to enable a fastener to be inserted across two bones into a position that will not be in the path of the bone plate screws when they are inserted. Thebody310 may also include a throughhole320 in theattachment portion314 of thebody310, as seen inFIGS. 20-21. Further, thebody310 may include analignment protrusion322 extending away from theattachment portion314, as shown inFIGS. 17-20, for engaging an opening in a bone plate, such asbone plate100,200, or the like. Thealignment protrusion322 may be used to position the bone platealignment guide apparatus300 with respect to a bone plate.

Thealignment guide300 may be used withplates100 and200. Thealignment guide300 andplate100 or200 form a bone plate insertion system that allows for the insertion of a crossing fastener and the bone plate screws without either contacting the other. Thus, the bone plate insertion systems provide a surgeon the ability to precisely place the crossing fastener and bone plate screws without the need for additional imaging or trial and error, thereby improving the surgical procedure.

Referring now toFIG. 22, a method of using the step offbone plate systems100,200 is shown. As illustrated inFIG. 22, the method may include preparing the patient'sbones400 and aligning the patient'sbones410. Next, the method may include selecting abone plate420 and attaching an insertion guide to thebone plate430. Once the bone plate is coupled to the insertion guide, the bone plate may be aligned on the patient'sbones440. Then, the bone plate may be secured to the patient's bones withtemporary fixation members450. After the bone plate is secured to the bones, a guide wire may be inserted across the patient's joint460 and the insertion guide may then be removed from thebone plate470. Next, the guide wire may be used to insert a screw across the joint380. Finally, the screws may be inserted to secure the plate to the bones and the temporary fixation members removed490.

The method as shown inFIG. 22 may be described in greater detail with reference toFIGS. 1-21. First, the surgeon will prepare the patient's bones by selecting the cartilage removal technique, for example, curettage or sagittal saw blade. If the surgeon selects to use a curettage, then the correction method will be translation of the bone, for example, the metatarsal. However, if the surgeon selects to use a sagittal saw blade, then the correction method will be angular correction of the joint, for example, the tarso-metatarsal joint. Once the bones are prepared, they will be aligned for fixation and a guide wire may be inserted to temporarily stabilize the joint. The surgeon will then select a bone plate, for example,bone plate100,200 or another similarly shaped plate, which adequately spans the joint space. By way of specific example, thebone plates100,200 would likely be used when the surgeon is using a translation method to correct the deformity. Next, a bone platealignment guide apparatus300 may be secured to the selectedbone plate100,200. Theapparatus300 may be secured by aligning thealignment protrusion322 of theguide300 with an opening (not shown) in theplate100,200 and insertingcoupling member330 through theopening320 in thebody310 and securing theengagement portion336 to another opening in theplate100,200.

Once theguide300 is coupled to theplate100,200, theplate100,200 may be aligned onto the patient's bones. Theplate100,200 is aligned with the long axis of theplate100,200 being parallel to the long axis of the bone, for example, metatarsal bone, to ensure proper orientation of theguide300. Next, theplate100,200 is secured to the bones using at least two temporary fixation members, for example, olive wires. The first temporary fixation member may be inserted into the proximal screw hole in theplate100,200 and the second into a second opening in theplate100,200. For example, the first temporary fixation member may be inserted intoopenings124,128 or224,228 and the second temporary fixation member may be inserted into theslot112,212. After theplate100,200 is secured to the bones, the guidepin tissue protector340 may be inserted into one of the throughholes318 in thebody310. Then, a guide wire may be inserted through thehole346 and across the joint. Once the guide wire is determined to be in the correct position, theprotector340 may be removed from thebody310 and thecoupling member330 may be disengaged from thebone plate100,200 and thecoupling member330 andbody310 removed from thebone plate100,200.

After theguide300 is removed, a screw insertion technique for inserting a crossing fastener, for example, a compression lag screw, may be employed to insert the crossing fastener through the joint. The crossing fastener is preferably inserted over the guide wire to obtain proper positioning to avoid contact with the bone plate screws when they are later inserted. Once the fastener is inserted, the guide wire may be removed. Next, screws (not shown) may be inserted into the patient's bones through thebone plate100,200. The screws may be inserted by, for example, using a threaded drill guide to drill the openings for the screws, then the openings are measured, and finally the screws are inserted into the openings. The screws may be, for example, locking screws, non-locking screws, or a combination thereof. The screws will be inserted without contacting the crossing fastener because theguide300 correctly positions the crossing fastener such that it is not in the path of any of the bone plate screw openings. Once theplate100,200 is secured to the patient's bones, any olive wires, k-wires, or guide wires that have not yet been removed from the patient's bones may be removed. Finally, the patient's surgical opening may be closed.

The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has”, and “having”), “include” (and any form of include, such as “includes” and “including”), and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a method or device that “comprises,” “has,” “includes,” or “contains” one or more steps or elements possesses those one or more steps or elements, but is not limited to possessing only those one or more steps or elements. Likewise, a step of a method or an element of a device that “comprises,” “has,” “includes,” or “contains” one or more features possesses those one or more features, but is not limited to possessing only those one or more features. Furthermore, a device or structure that is configured in a certain way is configured in at least that way, but may also be configured in ways that are not listed.

The invention has been described with reference to the preferred embodiments. It will be understood that the architectural and operational embodiments described herein are exemplary of a plurality of possible arrangements to provide the same general features, characteristics, and general system operation. Modifications and alterations will occur to others upon a reading and understanding of the preceding detailed description. It is intended that the invention be construed as including all such modifications and alterations.

Claims (19)

Having thus described the preferred embodiments, the invention is now claimed to be:

1. A bone plate, comprising:

a body with a first end and a second end, the body further comprising;

a first portion with a first curvature;

a second portion with a second curvature; and

a connecting portion, wherein the connecting portion connects the first portion to the second portion and provides a change in elevation, wherein the connecting portion comprises:

a sloped surface on a top of the body connecting a top surface of the first portion with a top surface of the second portion;

a transition point positioned on a bottom of the body;

a first transition portion on the bottom of the body and extending from the first portion to the transition point; and

a second transition portion on the bottom of the body and extending perpendicular to the first transition portion from the transition point to the second portion;

wherein the first curvature and the second curvature are curved in a transverse plane of the body, and wherein the first curvature is larger than the second curvature.

2. The bone plate ofclaim 1, wherein the first curvature ranges from 8 mm to 60 mm.

3. The bone plate ofclaim 1, wherein the body is curved along a longitudinal axis.

4. The bone plate ofclaim 3, wherein the curvature along the longitudinal axis ranges from 50 mm to 300 mm.

5. A bone plate, comprising:

a body with a first end and a second end, the body further comprising;

a first portion with a first curvature, wherein the first portion comprises:

an extension arm extending away from a side of the body; and

a slot extending through the first portion of the body near the first end;

a second portion with a second curvature; and

a connecting portion, wherein the connecting portion connects the first portion to the second portion and provides a change in elevation, wherein the connecting portion comprises:

a sloped surface on a top of the body connecting a top surface of the first portion with a top surface of the second portion;

a transition point positioned on a bottom of the body;

a first transition portion on the bottom of the body and extending from the first portion to the transition point; and

a second transition portion on the bottom of the body and extending perpendicular to the first transition portion from the transition point to the second portion.

6. The bone plate ofclaim 5, wherein the first portion further comprises:

a first opening extending through the body adjacent to the slot; and

a second opening extending through the extension arm.

7. The bone plate ofclaim 6, wherein the second portion comprises:

a first lobe; and

a second lobe offset from the first lobe.

8. The bone plate ofclaim 7, wherein the second portion further comprises:

a ramped surface on the second end of the body, wherein the ramped surface decreases the thickness of the bone plate at the second end.

9. The bone plate ofclaim 8, wherein the ramped surface is angled from a bottom surface of the body to a top surface of the body.

10. The bone plate ofclaim 9, wherein the first lobe and second lobe each include an opening extending from a top surface of the second portion through a bottom surface of the second portion.

11. The bone plate ofclaim 10, wherein the connecting portion comprises a distance between the bottom surface of the first portion and the top surface of the second portion, wherein the distance is perpendicular to the longitudinal axis of the body.

12. The bone plate ofclaim 11, wherein the first portion is fixed to a bottom of the connecting portion and the second portion is fixed to a top of the connecting portion.

13. The bone plate ofclaim 12, wherein the first portion is offset in a vertical direction from the second portion.

14. The bone plate ofclaim 5, wherein the extension arm is curved along the first curvature of the first portion and angled toward the second portion.

15. A bone plate insertion system, comprising:

a bone plate with a first end and a second end, the bone plate further comprising;

a first portion with a first curvature;

a second portion with a second curvature; and

a connecting portion, wherein the connecting portion connects the first portion to the second portion and provides a change in elevation between the first portion and the second portion, wherein the connecting portion comprises:

a sloped surface on a top of the body connecting a top surface of the first portion with a top surface of the second portion;

a transition point on the bottom of the body;

a first transition portion on the bottom of the body and extending from the first portion to the transition point; and

a second transition portion on the bottom of the body, extending perpendicular to the first transition portion from the transition point to the second portion; and

an alignment guide apparatus, wherein the alignment guide apparatus comprises:

a body comprising:

an arm with a first end and a second end;

an attachment portion at the first end for engaging the bone plate; and

an alignment portion at the second end with at least one opening for positioning a crossing fastener.

16. The bone plate insertion system ofclaim 15, wherein the alignment guide apparatus, further comprises:

a coupling member with a knob and a shaft, wherein the shaft passes through the attachment portion;

a protector member with a handle portion and a shaft portion, wherein the shaft portion passes through the alignment portion;

wherein the coupling member attaches the alignment guide apparatus to the bone plate.

17. The bone plate insertion system ofclaim 16, wherein the alignment portion is square.

18. A method for using a step off bone plate, comprising:

preparing and aligning a patient's bones;

selecting a step off bone plate;

attaching an insertion guide to the step off bone plate;

aligning the step off bone plate over the bones;

securing the bone plate to the bones with temporary fixation members;

inserting a guide wire through the insertion guide and across the bones;

removing the insertion guide from the step off bone plate;

inserting a crossing fastener over the guide wire and across the bones; and

inserting bone screws through the plate to secure the plate to the patient's bones, and wherein the insertion guide positions the crossing fastener to avoid intersecting with the bone screws.

19. The method ofclaim 18, wherein the step off bone plate comprises:

a body with a first end and a second end, the body further comprising;

a first portion with a first curvature;

a second portion with a second curvature; and

a connecting portion, wherein the connecting portion connects the first portion to the second portion, and provides a change in elevation, wherein the connecting portion comprises:

a surface on a top of the body connecting a top surface of the first portion with a top surface of the second portion;

a transition point positioned on a bottom of the body;

a first transition portion on the bottom of the body that extends from the first portion to the transition point; and

a second transition portion on the bottom of the body extending from the transition point to the second portion.

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